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You could be having an allergic reaction or could be taking too high of a dose

Further reading: Vitamin B12 Supplements and Vitamin B12 Dosages Oral Vitamin B12 Supplements for Mild Nerve Disorders The previously tested protocols for the oral treatment of nerve disorders with B12 work with multiple doses per day

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Yes, tirzepatide may reduce the effectiveness of oral hormonal contraceptives due to delayed gastric emptying